Does Medicare Cover Birth Control

Does Medicare Cover Birth Control

Birth control is among the essential items for women who are married or in a relationship. Family planning is essential today and birth control plays a crucial role in maintaining the population.

However, as most birth control products tend to be expensive, not everyone can afford these by paying out of their pockets. Hence, people turn to health insurance policies to get birth control products.

Does Medicare cover birth control? This is one of the most frequently asked questions from Medicare beneficiaries. This article will answer the question completely.

Does Medicare Cover Birth Control? – Medicare and Birth Control

CDC reports that 65% of women between 15 and 49 years of age used a form of birth control during the period from 2017 to 2019. Some of the most commonly used birth control pills and devices in the US include:

  • Birth control pills
  • Injectable birth control medications
  • Contraceptive implants
  • Birth control path
  • Intrauterine devices (IUDs)
  • Vaginal ring
  • Vasectomy
  • Hysterectomy

Original Medicare (Part B) covers certain types of contraceptive services, such as contraceptive counseling for women who are at risk of pregnancy, when provided in a primary care setting.

Medicare Part D plans may cover FDA-approved contraceptive drugs prescribed by a doctor, but coverage varies by plan. Medicare Advantage plans may also offer additional benefits, including coverage for some contraceptive services or supplies, but specifics vary by plan.

Original Medicare and Birth Control

Original Medicare combines Part A and Part B. Part A Medicare offers coverage for inpatient healthcare expenses.

Medicare Part B covers outpatient care, including doctor’s visits, preventive services, therapies, and diagnostic tests.

Medicare Part B offers coverage for numerous types of preventive care treatments. These include vaccines and health screenings.

However, birth control pills and devices are not included under preventive medicine within Medicare Part B.

Original Medicare does not cover most elective procedures, but it may cover certain procedures if deemed medically necessary. For instance, you should not expect Original Medicare to cover the cost of implanting birth control devices or vasectomies.

However, there are certain instances where birth control drugs or devices may be medically necessary to treat certain health conditions.

For example, a hysterectomy may be advised to treat a severe health condition. Several health conditions, such as ovarian cysts, can also be treated using birth control pills.

In such cases, Medicare may provide coverage for medications and procedures to treat another medical condition.

Medicare Part D and Birth Control

Medicare Part D is designed to pay the cost of prescription drugs. The specific prescription medications covered may vary from one insurance company to another.

It also depends on your specific Medicare Part D plan. Once your policy application is approved, you will receive a list of prescription drugs covered under Medicare Part D.

Several Medicare Part D plans offer coverage for birth control medications.

Always check the offered documents carefully and ensure that birth control medications are covered under your chosen plan.

Medicare Advantage and Birth Control

Medicare Part C, or Medicare Advantage, can be bought directly from a private insurance vendor.

This insurance offers the usual benefits offered under Original Medicare along with additional benefits, such as dental and vision care.

Read the documents carefully to ensure that your Medicare Advantage plan offers coverage for birth control procedures.

Several Medicare Advantage plans include prescription drug coverage, similar to Part D policies.

Make sure to check the offered list of drugs and procedures to ensure that birth control medications are covered.

Medicare Supplement Plans and Birth Control

Medigap, the Medicare Supplement Plan, covers some Medicare costs, such as coinsurance, copays, and deductibles.

Medicare Supplement Insurance (Medigap) plans help pay some out-of-pocket costs that Original Medicare (Part A and B) does not cover, such as copayments, coinsurance, and deductibles. Medigap plans do not cover additional services or medications that Original Medicare does not cover, including birth control.

Cost of Birth Control with Medicare

The cost of birth control under Medicare Part D and Medicare Advantage plans varies. Its exact cost is determined by your choice of plan and its extent of coverage.

Make sure to consult with your physician before buying a Medicare plan for birth control benefits.

Conclusion

Original Medicare does not generally cover birth control unless it is part of a medically necessary procedure. Medicare Part D and Medicare Advantage plan coverage for birth control varies by plan, and beneficiaries should review their plan details for specific coverage information.

Although some Medicare Part D and Medicare Advantage plans do cover the cost of birth control pills and procedures.

If you regularly need birth control, then it is highly advisable to switch to the Medicare Advantage plan, as it includes coverage for several birth control pills and procedures.

Before buying any Medicare insurance plan, check with your plan administrator to ensure that birth control pills are included in the coverage.

See Also

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Current Version
August 17, 2023
Updated By
Andrea Morales G.
March 26, 2024
Updated By
Andrea Morales G.

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